Table 2 Summary of integration of behaviour change techniques to support exercise within intervention and resources
Behaviour change technique | Written information | Physiotherapist discussion | Other |
|---|---|---|---|
1. Consequences of behaviour | |||
 Explanation of benefits of strengthening exercise (AS, S) and aerobic physical activity (AS) | ✓ Osteoarthritis information booklet | ✓ Session 1 ✓ As dictated by patient Sessions 2–9 with checks on understanding | ✓ Telephone screening ✓ Baseline assessment |
 Explanation that exercise & physical activity will not worsen joint structural damage (AS, S) | ✓ Osteoarthritis information booklet | ✓ Session 1 ✓ As dictated by patient sessions 2–9 with checks on understanding | ✓ Telephone screening |
2. Goal setting | |||
 Development of specific goals related to patient’s hip problems (goal setting – outcome) (AS, S) | ✓ Session 1 | ||
 Development of specific exercise goals (goal setting – behaviour) (AS, S) | ✓ Sessions 2–9 | ||
3. Action planning | |||
 Use of a plan stating how often to exercise & which exercises to do (including dosage) (AS, S) | ✓ Exercise logbook | ✓ Each session | |
4. Barrier identification/problem solving | |||
 Information & discussion about barriers to exercise (AS, S) & physical activity (AS) adherence, including problem-solving | ✓ Osteoarthritis information booklet | ✓ Each session, transition from barriers and facilitators to self-management/regulation in the absence of physiotherapy contact in the final 3 sessions | |
5. Behavioural grading | |||
 Strengthening exercises are graded in number, intensity and/or difficulty to get progressively harder over time. (AS, S) | ✓ Osteoarthritis information booklet ✓ Exercise logbook | ✓ Each session | ✓ Four graded resistance bands ✓ Adjustable ankle-cuff weights |
6. Instruction & information | |||
 Instruction in where, when and how to perform strengthening exercises. (AS, S) | ✓ Exercise logbook ✓ Exercise booklet | ✓ Each session | |
 Demonstration of how to perform strengthening exercises. (AS, S) | ✓ Exercise booklet | ✓ Each session | |
 Demonstration of how to reach desired heart rate intensity for aerobic exercise (AS) | ✓ Telephone consult with Trial Coordinator +/− during lab baseline assessment for those who attend | ||
7. Self-monitoring & feedback | |||
 Encouraged to self-monitor strengthening exercise (AS, S) and aerobic exercise (AS) intensity | ✓ Exercise logbook ✓ Exercise booklet | Each session | ✓ Garmin provided and instructions to combined group to monitor heart rate |
 Encouraged to record strengthening (AS, S) and aerobic (AS) completed exercises | ✓ Exercise logbook | ✓ Each session | |
 Physiotherapist review of & and feedback on exercise recorded. | ✓ Ongoing throughout program, greater focus weeks 1–6 | ||
8. Relapse prevention | |||
 Instruction on how to modify exercise & physical activity during flare-ups. (AS, S) | ✓ Each session | ||
 Planning for setbacks in physical activity & how to overcome them. (AS) | ✓ Ongoing throughout physiotherapy sessions, strong focus final 3 sessions | ||
 Dealing with lapses & setbacks with exercise & physical activity; use of constructive self-talk. (AS, S) | ✓ Ongoing throughout physiotherapy sessions, strong focus final 3 sessions | ||
9. Emotional control | |||
 Encouraged to use activity pacing & pain coping activities | ✓ Osteoarthritis information booklet | ✓ Each session, as indicated by participant | |
 Encouraged to use pain coping strategies. | ✓ Osteoarthritis information booklet | ||
10. Prompts | |||
 Encouraged to use reminders to exercise. | ✓ Exercise logbook | ||
11. Rewards | |||
 Physiotherapist congratulates adherence to exercise. | ✓ Ongoing throughout physiotherapy sessions, specific mid-point review of goals at six weeks | ||
 Options discussed to use self-rewards for attempts towards goals as well as positive reinforcement towards achieving goals | ✓ Session 7, reflection on strategies for positive reinforcement | ||
12. Social support and accountability | |||
 Encouraged to involve partner or family to join in with exercising and beyond social accountability to physiotherapy | ✓ Session 7, discussion to shift social accountability from physiotherapy | ||
13. Review | |||
 Review, supervision and correction of strengthening exercise technique. | ✓ Each session | ||
 Review of tracked minutes of aerobic physical activity (AS) | ✓ Each session | ✓ Garmin tracking application | |
 Review of outcome goals at follow-up. | ✓ Session 7 | ||